Thank you for your interest in pursuing a credential with the International Christian Coaching Institute (ICCI). Please complete all requested information in all sections or mark "N/A" if not applicable. You may save your work and resume the process at a later time, but please note that uploads will not be saved.

ICCI will not disclose the confidential information given in this application to a third party without your express, written consent. Please allow 1-3 weeks for processing.

Demographics

This information will update your profile information.

Education/Training in Christian Life Coaching

• I Agree

National Institute of Clinical Applied Behavior Medicine Course- helping stuck clients course
Certified Autism Specialist- coaching clients on the autism spectrum
NeuroDiverse Love online conference- coaching ND couples
AACC Leslie Vernick Course Abuse, Trauma Emotionally Destructive Marriages
AACC Mental Health coaching course to completion 101, 201, 301
AACC Coffee cup counsel
ICCI Conference 2022
Equipping Profile Course and mentor with Gary Morais
Emotional Intelligence in Christ- building Christ base identity course and book
Other half of course- Wilder material Life Model coaching/counsel
Emotionally healthy leadership course Scazzero
Emotionally healthy relationships course Scazzero
Multiple June Hunt books
AACC World Conference 2023, 2021, 2019, 2017, 2015, 2013, 2011, 2001, 1999
AACC National Conference or Mega National 2010, 2012, 2014
Writing my own curriculum for Neurodiverse Christian couples for certification
Master's Counselling
Doctorate Education
Former LPC #4011 Nc 2000-2009
Ga Board of Examiners for Christian Counselors 2009- Present
Ordained minister since 2008

Coaching Hours
Leslie Vernick
Gary Morais
Diane Ellis Cunningham
Supervision for my license (former supervisors have passed away Dr. Robert Shive, Dr. Snipes)
Daryle Hines

Mentoring in Christian Life Coaching

• I Agree

Field Experience in Christian Life Coaching

• I Agree

I began transitioning from counseling to coaching in 2022. I work about 30 hours a week through Zoom.
I work with individuals on the spectrum coaching them through transitions, executive function skills, college and career
I work with marriages where one person is on the autism spectrum
I run groups based on the Equipping Profile
I run marriage groups

Other Professional Credentialing or Certification

Spiritual Orientation and Practice

Please define/describe your thoughts and beliefs on the following questions.

Jesus is my personal Lord and Savior. I received Christ when I was age 5 and was water baptized by the age of 8 or 9. At church we say our mission is to be with Jesus, become like Jesus, then do Jesus-y things. He is part of the Trinity of God the Father, God the Son and God the Holy Spirit. He is the Messiah and the only way to God the Father and eternal life.

Through confession of sin and asking Jesus to enter their life and be Lord of their life.

The Bible is the Word of God and give us guidelines on how to live our life. It is timeless.

The Holy Spirit is part of the Trinity and is our Paraclete or comforter one who walks along side us.

I was saved at 5 and raised in Assemblies of God. I walked with God all of my life, had a faith crises when my daughter was diagnosed with autism, but received support to return to my faith in the goodness of God. I felt called to ministry and completed seminary courses and am also an ordained minister.

I have newly discovered Dr. Jim Wilder (Life Model) and could write a book about how much I love incorporating neurological science and theology. Dr. Wilder's methods is based on joy building, hesed (attachment), healthy group identity, and healthy correction. I highly recommend him for a speaker at ICCI. I come from counseling arena of CBT and reality and solution based approaches.
With those on the spectrum, I have found a coaching approach works best working on specific goals.
I mostly work with Christ followers so am able to incorporate faith and neuroscience and personal goals.

ICCI Applicant Attestation

Note: The following statements require your attestation (affirming each one to be true to the best of your knowledge). Please be sure to respond to each and every section regarding yourself and your Life Coaching practice or ministry.

The foundation to all work and identity as a Christian Life Coach is a living, vibrant, and personal relationship with Jesus Christ. The following statements require your attestation (affirming each one to be true to the best of your knowledge). Please be sure to review each and every section that directly pertains to you and your professional life coaching, and/or ministerial work. The information it contains is important and will be referenced in the Application Form. Depending on your responses, additional information may be required in order to process your Application. 

SECTION A: Christian Personal Testimony

SECTION B: Christian Coaching Testimony (Required)

The practice of Christian Life Coaching genuinely incorporates scriptural truths, biblical principles and guidance, and a Christian value system into one’s coaching/ministerial practice, theoretical orientation, and professional life. ICCI is dedicated to credentialing Christian Life Coaches, not simply people and lay helpers who happen to be Christian, but do not incorporate their faith into practice. Please respond to the following items by checking the appropriate box: (Required)

SECTION C: Ethical Integrity (Required)

Each applicant must demonstrate and maintain ethical integrity in all Life Coaching, ministerial, and professionally related activities. Please note that a Yes answer to any of the following questions will not necessarily disqualify you for the credential you are seeking. If the case has been properly remedied and/or disposed of, and you are under no current ethical complaint or investigation, then the application process can proceed. Please respond to the following items by checking the appropriate box:

In 2021 and 2022 a former client was angry because I had to involve child protective services because he was abusive to his child.
He was formally diagnosed OCD by another professional and Asperger's/Autism by me.
He left marks on his child with a belt and wooden spoon after an agreement that he would not administer any corporates punishments to his ADHD and AS children because he was angry and it crossed the line. His wife left him and he accused me of "making her a feminist" and "mind control."
He filed an office with the Office of Civil Rights saying I violated his parental rights as an Autistic male "siding" with his wife in the GAL report. He then filed with GA. Board of Examiners for Christian Counselors and Therapists saying he was not autistic and because of my misdiagnosis his wife left him.
The Office of Civil Rights- just let me know it was filed but said there no evidence of abuse and no complaint on my record.
I went through an inquiry of the board, it was established I am an expert in the field of Autism. The wife supplies a letter about abuse to her and the children and she files for divorce for the safety of the children. While it was a frustrating situation; no charges nothing on my record either place.

• I Agree

ICCI Applicant Agreement

CERTIFICATION

Applicants certify all information in the Application Packet is true and complete, and understand they have the burden of producing all information necessary for ICCI to fairly and fully evaluate their qualifications, background, ethics, and Christian character in order to be considered for one of the ICCI credentials. They agree to inform ICCI of any changes in this information. Misstatements or omissions from the Application may be cause for denial of appointment or reappointment of the credential. Applicants further agree that any subsequent adverse information about them and/or their practice may be cause for disciplinary action – including the possibility of having the credential suspended or revoked.

AUTHORIZATION

Applicants authorize and give the ICCI consent to contact and, without restriction, discuss any issues pertaining to their character and qualifications with individuals submitting recommendation forms or providing mentoring services. Consent is given for the release of all information, records, and documents, by whatever means the ICCI chooses to collect this data, and to assist them in the good-faith evaluation of their Application. If a question arises in the future about their character and qualifications to the credential, they agree to assist the ICCI in its efforts to resolve any questions it may have.

INDEMNIFICATION

Applicants release from any and all liability ICCI, Hope Together Network, LLC, Hope for the Heart, JAWS, LLC, and any individual officers, directors, employees, or agents of these organizations for any and all acts done in good faith and without malice or intent to harm in connection with the evaluation of their Application for an ICCI credential.

DISPUTE RESOLUTION

If a dispute arises between the applicant and ICCI regarding the application or any future matter, applicants agree to engage in dispute resolution that (1) first attempts direct negotiation; (2) then attempts mediation with a mediator acceptable to both parties; (3) then uses arbitration and binding arbitration to resolve the matter, which mediation/arbitration shall take place in Dallas, Texas.

CREDENTIAL RESOLUTION

Applicants resolve to support the mission and goals of the ICCI and further agree to abide by and fully adhere to the ICCI Doctrinal Statement. They have not hidden, nor omitted any necessary information related to receiving the credential. If they qualify, they will hold their ICCI credential in the highest regard, honor the calling of God in Christian Life Coaching, and maintain both excellence and an ethical stance as a servant-leader in the field. Furthermore, they will strive to avoid all behavior that compromises the name of Christ, the cause of Christian Life Coaching, and the purposes of the ICCI.

Applicants acknowledge they have read, discussed as needed, and fully understand this Agreement. They acknowledge that by signing the formal Application Form, they do hereby agree with all consent and authorization statements that are described herein.

• I Agree

Credential Requirements

Basic Requirements

Continuing Education Requirements

All ICCI credential holders are required to obtain 15 CONTACT HOURS of Continuing Education on an annual basis and these hours must incorporate biblical principles and coaching skills with theory, knowledge, and practice.

Continuing Education is a term that applies to obtaining contact hours across a broad range of post-secondary (beyond high school) learning activities and programs. Some examples include degree credit courses, non-degree career training, self-directed learning, experiential learning, seminars, symposiums, workshops, conference presentations, and classroom lectures. The method and format of delivery may be face-to-face, distance/online learning, printed texts/workbooks, the use of videotaped materials, etc.

ICCI approved Continuing Education and competency activities can occur in the following categories:

Category #1: Continuing Education activities that the credential holder ENGAGES in as a RECIPIENT

NOTE: A minimum of ten (10) contact hours of the required total number of hours must be from Category #1

• Formally organized learning (college/university courses, workshops, seminars, professional or ministerial conferences, presentations, home study, etc.). The delivery of content may be either face-to-face or electronic (e.g., CD, DVD, computer, Web-based, etc.)
• Training experiences at churches or other Christian organizations that resulted in a certificate of completion or other verifiable documentation of participation
• Publications (e.g., journals, magazines, etc.) that have a CE component and a process providing verification of completion
• Coaching supervision and/or consultation that is received and documented

Category #2: Continuing Education activities that the credential holder PROVIDES as a FACILITATOR

• Facilitating, training or presenting at an organized conference/seminar/class that incorporates biblical principles and life coaching skills with theory, knowledge, and practice (the same presentation may only be used once in a renewal period)
• Teaching a post-secondary class that incorporates biblical principles and life coaching skills with theory, knowledge, and practice (the same course may only be used once in a renewal period)
• Producing new training materials and/or curriculum that incorporates biblical principles and coaching skills with theory, knowledge, and practice
• Publishing (a book, book chapter, journal/magazine article, etc.)

Acceptable Forms of Documentation for Continuing Education activities:

• Certificates of Completion
• CE letters or other forms documenting participation
• Official transcripts and/or diplomas
• Reprints of published articles, book chapters, training materials, etc.
• Proof of presentations that were given and/or courses that were taught
• Formal letters from supervisors and/or consultants

• I Agree

References

Processing your application begins when all references are received. Please alert your references to watch for emails from ICCI requesting their reference for your credential approval. White-listing our email address ([email protected]) will ensure emails arrive in inboxes rather than spam/junk folders

Sign and Send

• I Agree

I affirm and attest by my electronic signature below that I have answered all questions in this Application truthfully and have done so to the best of my knowledge and with full disclosure. I further authorize ICCI to verify this information and understand that in the process of verification, these facts might become known to third parties. I expressively waive any claim to confidentiality of the material enclosed in this Application except where otherwise noted.